Jacqueline Burditt, OTA/L

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

U2-0001873 Issued in DE

Practice address

311 Marldale Dr
Middletown, DE 19709-1717

Phone

(302) 373-9941

NPI assigned

Jun 19, 2014

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Jacqueline Shields Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1403136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556668800000",
    "number": "1457765307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "311 MARLDALE DR",
            "city": "MIDDLETOWN",
            "state": "DE",
            "postal_code": "197091717",
            "telephone_number": "302-373-9941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "311 MARLDALE DR",
            "city": "MIDDLETOWN",
            "state": "DE",
            "postal_code": "197091717",
            "telephone_number": "302-373-9941"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "307 S Broad St",
            "address_purpose": "LOCATION",
            "city": "Middletown",
            "state": "DE",
            "postal_code": "197091407",
            "country_code": "US",
            "telephone_number": "302-373-9941",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BURDITT",
        "first_name": "JACQUELINE",
        "credential": "OTA/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-06-19",
        "last_updated": "2019-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "DE",
            "license": "U2-0001873",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JACQUELINE",
            "last_name": "SHIELDS",
            "credential": "OTA/L",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Philip Richard Brown, D.C
• Sherreika Brown, LCSW
• William Brown III
• Joy Christine Brusetti, LMT, BCTMB
• Kylie Bumgarner
• Christopher Burris, PHARMD
• Patricia J Bush, LPCMH, MS, BS, AA
• Michaela Byrd
• Michelle Calder
• Callaway Franceschini LLC

• Occupational Therapy Assistant in Middletown, DE
• Providers in Middletown, DE by specialty
• Occupational Therapy Assistant in Delaware

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.